We report a case of a 41-year-old man with a mature cystic teratoma (MCT) of the pancreas, who presented with a 6-month history of dull, aching pain and tense, globular, ill-defined upper abdominal swelling. Cystectomy revealed a cyst containing hair and a tooth.

Gallbladder strictures are rare and can be either congenital or acquired. A gallbladder stricture can often be confused for a choledochal cyst on imaging, including MRCP. ERCP has a higher sensitivity and should be used if imaging findings are uncertain.

VBDS is an acquired disorder resulting in progressive destruction and disappearance of the intrahepatic bile ducts. VBDS is a rare cause of jaundice in patients with Hodgkin’s and non-Hodgkin’s diseases such as ALCL.

Somatostatinoma of the gastrointestinal tract is a rare finding, especially arising from the ampulla of Vater. We present a man recently diagnosed with rectal adenocarcinoma who was found to have an ampullary mass consistent with a nonfunctioning somatostatinoma.

We report a patient with gastrointestinal bleeding in whom pneumobilia was incidentally noted on abdominal plain film. Computed tomography and endoscopy revealed the biliary-enteric fistula to be caused by metastatic colon adenocarcinoma invading the biliary tree.

A 33-year-old woman with a history of intravenous cocaine abuse presented with fatigue, nausea, and jaundice.Surgical excision of a partially obstructing lesion in the common hepatic duct, revealed a granular cell tumor, with immunohistochemical staining of tumor cells positive for S-100.

In a patient found to have cholelithiasis and choledocholithiasis, a choledochoduodenal fistula was used to gain access to the bile duct. Due to severe stenosis and atrophy of the major papilla, cannulation was not possible.

Takotsubo cardiomyopathy, also known as left ventricular apical ballooning, broken heart syndrome,
and stress cardiomyopathy, is so named due to its resemblance of a Japanese octopus trap, a tako tsubo. Acute pancreatitis as a trigger for TCM has rarely been reported.

We present a man with a hypoechoic mass in the neck of the gallbladder and the muscularis propria of the duodenum. Examination of the resected gallbladder and perihilar nodes ruled out malignancy and revealed a diffuse inflammatory infiltrate of giant histiocytes with clear, lipid-containing cytoplasm (xanthoma cells), consistent with xanthogranulomatous cholecystitis.

A 56-year-old woman underwent emergent TIPS due to a ruptured esophageal varix during esophagogastroduodenoscopy. Following TIPS, she experienced bilhemia, a rapid rise in serum bilirubin with no evidence of biliary obstruction or hepatic injury. Bilhemia is a rare but serious complication of TIPS.

Intraductal papillary mucinous neoplasms (IPMN) arise from main pancreatic and/or branch ducts, and are characterized by intraductal papillary proliferation of mucin-producing epithelial cells exhibiting various degrees of dysplasia. We present 3 cases of IPMN: without dysplasia, with high-grade dysplasia, and with invasive carcinoma.

A 69-year-old man was admitted for painless jaundice and a 2-week history of pruritus, dark urine, and acholic stools, and represents the third case of an intracholedochal metastatic lesion without simultaneous liver involvement reported in the literature.

We report the only known case of eosinophilic pancreatitis (EP) in which the diagnosis was made by fine needle aspiration and core biopsy of the pancreas during EUS, sparing the patient a surgical resection.

Although acalculous cholecystitis typically occurs in critically ill individuals, it has been described in patients with HIV infection. We present a case of acalculous cholecystitis caused by H. capsulatum in a patient with HIV infection.

A 20-year-old male underwent TIPS placement, but soon after had mild left intrahepatic biliary dilatation without stones or obvious stricture. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated a focal stricture due to compression by the TIPS.

A 53-year-old male presented with a small fistula between the proximal biliary tree/porta hepatis and the duodenal bulb, likely secondary to previous chemotherapy and radiation. A stent was placed in this fistula, as this was the only pathway available for biliary drainage.

We report a challenging case of systemic diffuse large B-cell lymphoma (DLBCL) that initially presented with septic shock from acalculous cholecystitis. After extensive investigation, DLBCL was found to be the underlying cause of gallbladder disease.

A 49-year-old woman with cholangiocarcinoma metastatic to the lungs presented with new-onset unrelenting headaches. A lumbar puncture revealed malignant cells consistent with leptomeningeal metastasis from her cholangiocarcinoma. An intrathecal (IT) catheter was placed and IT chemotherapy was initiated with methotrexate.

Intramural hematomas have rarely been associated with pancreatitis. We describe a patient who presented with gastric outlet obstruction secondary to a spontaneous intramural duodenal hematoma and was found to have a pancreatic adenocarcinoma on EUS.

A 43-year-old woman presented with recurring upper abdominal pain, a bilirubin of 4.7 mg/dL, and liver enzymes more than 5 times the upper limit of normal. Abdominal CT demonstrated a wedge-shaped area of decreased attenuation in liver segment III. A living Fasciola hepatica parasite was removed from the common bile duct via ERCP.

Hemosuccus pancreaticus (HP) is a rare cause of gastrointestinal bleeding (GIB) that should be considered in a patient with a history of pancreatitis and GIB. We describe an unusual presentation of HP in a 17-year-old female with a history acute idiopathic pancreatitis who presented with nausea followed by an episode of hematemesis.

Groove pancreatitis is a rare form of chronic pancreatitis that affects the groove anatomical area between the head of the pancreas, duodenum, and common bile duct. We provide a summary of the clinical findings of 4 groove pancreatitis cases diagnosed at a tertiary academic medical center over a 5-year period, and a detailed literature review.

Bouveret’s syndrome is a cause of gastric outlet obstruction that results from the passage and impaction of a large gallstone through a cholecystoduodenal fistula. We describe a unique variant of chronic Bouveret’s syndrome with the unusual associations of severe esophagitis and a purulent fistula.

A patient with modified multivisceral transplant developed recurrent acute pancreatitis (RAP) 1 year after transplant and was found to have graft pancreas divisum with otherwise negative work-up for identifying the etiology of RAP. Endoscopic retrograde cholangiopancreatography was performed with minor papilla sphincterotomy and pancreatic duct stent placement of the graft pancreas.

Isolated dissection of the celiac trunk is rare, and only a few cases have been reported in the medical literature. We report the case of a 51-year-old male who presented with abdominal pain and was subsequently diagnosed with a celiac trunk dissection with secondary pancreatitis and pancreatic infarction.

Pancreatic tumors with osteoclast-like giant cells are rare, with only 50 cases published to date. We report a case of a 67-year-old male with incidental pancreatic body mass on abdominal imaging. Cytology from the pancreatic mass obtained revealed an undifferentiated carcinoma with osteoclast-like giant cells.

Pancreaticopericardial fistula is an extremely rare complication of chronic pancreatitis and virtually unheard of in the setting of acute pancreatitis. A 67-year-old male presented with acute pancreatitis complicated by pancreaticopericardial fistulization. The patient’s initial presentation was consistent with tamponade physiology.

We report a case of a minor papilla adenoma in a patient with FAP and pancreas divisum, and we demonstrate the safety and feasibility of endoscopic management of minor papilla tumors in patients with FAP and associated pancreas divisum.

A 48-year-old female developed acute emphysematous cholecystitis after an endoscopic retrograde cholangiopancreatography (ERCP) for evaluation of sphincter of Oddi dysfunction. For next 3 years, patient had recurrent episodes of biliary obstruction, cholangitis, and sepsis, resulting in secondary biliary cirrhosis requiring a liver transplantation.